LINCOLN LUTHERAN COMMUNITY CARE CORPORATION (NPI# 1871677963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871677963 |
| Entity Type | Organization |
| Organization Name | LINCOLN LUTHERAN COMMUNITY CARE CORPORATION |
| Other Organization Name | BECKER SHOOP CENTER |
| Practice Address |
6101 16th Street Racine WI 53406 |
| Mailing Address |
2000 Domanik Drive Racine WI 53404 |
| Practice Telephone | 2626377486 |
| Practice Fax Number | 2626333045 |
| Mailing Telephone | 2626330500 |
| Mailing Fax Number | 2626333045 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | FRED RICHARD BOVA JR. (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2628982701 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | Y |
| Parent Organization Name | LINCOLN LUTHERAN HOME OF RACINE INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3179 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20177300 | 05 |
| Other Name | Type Code |
|---|---|
| Becker Shoop Center | Doing Business As Name - Organization |
| Street Address |
6101 16TH STREET |
| City | RACINE |
| State | WI |
| Zip Code | 53406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215011317 | Lincoln Lutheran Home of Racine Inc | Skilled Nursing Facility | 1700 Ca Becker Drive, Racine, WI 53406 | 2006-10-25 |
| 1831122431 | Ascension Living - Lakeshore At Siena, Inc. | Skilled Nursing Facility | 5643 Erie St, Racine, WI 53402-1934 | 2006-07-08 |
| 1649275991 | Racine County | Skilled Nursing Facility | 3205 Wood Rd, Racine, WI 53406-5048 | 2005-06-14 |
| 1346763729 | Complete Care At Ridgewood LLC | Skilled Nursing Facility | 3205 Wood Rd, Racine, WI 53406-5048 | 2017-07-18 |
| 1396126348 | Monica Doyle | Skilled Nursing Facility | 6101 16th St, Racine, WI 53406-4467 | 2015-06-16 |
| 1477931756 | Villa At Lincoln Park, LLC | Skilled Nursing Facility | 1700 C A Becker Dr, Racine, WI 53406-4714 | 2015-05-07 |
| 1548539323 | Ridgewood | Skilled Nursing Facility | 3205 Wood Rd, Racine, WI 53406-5048 | 2011-12-22 |
| 1316147895 | Angel L Platzer | Skilled Nursing Facility | 6101 16th St, Racine, WI 53406-4467 | 2007-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962369 | Heritage Assisted Living, LLC | Skilled Nursing Facility | 5020 S 107th St, Greenfield, WI 53228-3267 | 2020-04-30 |
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1831693936 | Golden Years Nursing Home, Inc. | Skilled Nursing Facility | 611 Harmony Dr, Lake Geneva, WI 53147-8800 | 2018-03-22 |
| 1801302732 | Oak Park Place of Janesville, LLC | Skilled Nursing Facility | 700 Myrtle Way, Janesville, WI 53545-9101 | 2017-12-14 |
| 1235674839 | Zachary Rader | Skilled Nursing Facility | 645 N Church St, Elkhorn, WI 53121-2204 | 2017-01-05 |
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1316492317 | Darcy Christiansen | Skilled Nursing Facility | 4427 E Pic A Dilly Dr, Janesville, WI 53546-9606 | 2016-08-19 |
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1720433378 | Kendra Meyers | Skilled Nursing Facility | 1806 N Hume Ave Apt 4, Marshfield, WI 54449-1677 | 2016-05-02 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LINCOLN LUTHERAN COMMUNITY CARE CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.